Provider Demographics
NPI:1043838238
Name:RARDIN, AMBER CHRISTINE (PA-C)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:CHRISTINE
Last Name:RARDIN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4612 NASH ST N
Mailing Address - Street 2:
Mailing Address - City:WILSON
Mailing Address - State:NC
Mailing Address - Zip Code:27896-8725
Mailing Address - Country:US
Mailing Address - Phone:252-281-5044
Mailing Address - Fax:252-558-0242
Practice Address - Street 1:4612 NASH ST N
Practice Address - Street 2:
Practice Address - City:WILSON
Practice Address - State:NC
Practice Address - Zip Code:27896-8725
Practice Address - Country:US
Practice Address - Phone:252-281-5044
Practice Address - Fax:252-558-0242
Is Sole Proprietor?:No
Enumeration Date:2020-07-14
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010105922084P0800X
NC0010-10592363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry